Drug resistance profiles and trends in drug-resistant tuberculosis at a major hospital in Guizhou Province of China

Yuanbo Lan,1,* Yuqin Li,1,* Ling Chen,1 Jianyong Zhang,1 Hong Zhang1,2 1Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563003, China; 2Z-BioMed, Inc., Rockville, MD 20855, USA *These authors contributed equally to this work Objectives: Tuberculosis (TB) is the leading cause of death from infectious diseases in the world, with an estimated 1.6 million deaths from TB in 2017. The objectives of this study were to determine drug resistance profiles of Mycobacterium tuberculosis clinical isolates and to analyze the trends in drug-resistant and multidrug-resistant tuberculosis (MDR-TB) from 2008 to 2015 at a major hospital in Guizhou, a high-TB burden and resource-limited province of China. Patients and methods: A total of 462 clinical isolates were collected from patients with pulmonary TB during the period from January 2013 to December 2015 and used for determining drug resistance profiles against four first-line and six second-line anti-TB drugs, and the results were compared with those of two previous studies. Results: Exactly 4.4% of new and 44.1% of previously treated TB cases were MDR/rifampicin-resistant TB (RR-TB), which were higher than the 2017 global average numbers of 3.5% and 18%, respectively. There were many drug-resistant patterns among MDR-TB isolates and most of them were resistant to three or four anti-TB drugs. The trends in drug-resistant and MDR-TB declined at the hospital from 2008 to 2015. Conclusion: Results of this study show that the prevalence of MDR/RR-TB at a major hospital in Guizhou is higher than the global average and confirm the existence of heterogeneity in drug resistance patterns of MDR-TB isolates. Additionally, three practical measures have played an important role in the overall decline of MDR-TB at the hospital from 2008 to 2015. Keywords: Mycobacterium tuberculosis, anti-TB drugs, drug resistance patterns, trend